Pediatric CCRN Neurological Flashcards
6 cards from real Pediatric CCRN Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 6 Pediatric CCRN Neurological flashcards as text
A child with bacterial meningitis develops the sudden onset of a fixed dilated pupil and posturing. The nurse should FIRST:
Answer: Notify the physician immediately and prepare for emergent ICP management
A fixed dilated pupil with posturing signals cerebral herniation — an immediate life-threatening emergency requiring physician notification and emergent ICP management before any other action.
Which CSF finding is MOST consistent with bacterial meningitis in a child?
Answer: Cloudy CSF, WBC 2,000 (neutrophilic), glucose 25, protein 200
Bacterial meningitis produces cloudy CSF with a high neutrophilic pleocytosis, very low glucose (<40 mg/dL or CSF:serum ratio <0.4), and elevated protein due to purulent inflammation.
What is the mechanism of neurological injury in neonatal hypoxic-ischemic encephalopathy (HIE)?
Answer: Excitotoxicity from glutamate release during reperfusion after hypoxia
During reperfusion after hypoxia-ischemia, massive glutamate release triggers excitotoxicity, calcium influx, mitochondrial dysfunction, and programmed cell death in the vulnerable neonatal brain.
Therapeutic hypothermia for HIE is initiated at 33.5°C for 72 hours. It is CONTRAINDICATED in which scenario?
Answer: Gestational age <36 weeks
Therapeutic hypothermia is currently recommended only for neonates ≥36 weeks gestation; premature infants <36 weeks are excluded due to insufficient evidence and increased risk of complications.
A 7-year-old with a VP shunt presents with headache, vomiting, and a bulging fontanelle. Assessment reveals upward gaze palsy. What does upward gaze palsy indicate in this context?
Answer: Parinaud syndrome from dorsal midbrain compression due to hydrocephalus
Parinaud syndrome (paralysis of upward gaze) results from dorsal midbrain compression by an enlarged third ventricle in obstructive hydrocephalus — a classic sign of shunt failure.
Which anticonvulsant is PREFERRED for a neonate with seizures due to hypoglycemia?
Answer: Treat the underlying hypoglycemia with IV dextrose first
Neonatal seizures caused by hypoglycemia are metabolic in origin — correcting the glucose abnormality is the definitive treatment and should precede any anticonvulsant therapy.
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